Patient Information
Patient Forms
Alliance Oral & Maxillofacial Surgery welcomes you to our patient family. Here, you’ll find valuable information and tips about insurance, appointment scheduling and payment policies. We encourage you to browse this section thoroughly, and we hope you find answers to any lingering questions about our credentials, mission statement, and much more. We look forward to serving you and your family!
Patient Registration
Alliance Oral & Maxillofacial Surgery is all about patient convenience. That’s why we make the forms you need for your first appointment available on our website. Click the links at the top of this page to download the forms, then fill them out (black ink only, please), and bring them with you to your consultation. If you have any questions about these forms or need to change your appointment, please call us. We look forward to seeing you!
Your First Appointment
When you come in to see us for the first time, we’ll start by evaluating your condition, explaining your diagnosis, and proposing different treatment options. In some cases, we can perform some surgery the same day as the consultation. Typically, though, a patient’s medical history and/or treatment plan will require an evaluation at the first visit, then another appointment for the actual treatment.
You can help us out tremendously by having the following ready at the time of your consultation:
- A surgical referral slip and x-rays (if any)
- A complete list of your medications, including OTC
- A valid photo ID
- Completed Patient Registration forms
- Your medical and dental insurance cards
IMPORTANT
All patients under the age of 18 must be accompanied by a parent or guardian at the consultation visit.
If your procedure involves IV anesthesia, please do not eat or drink anything for eight hours prior to your surgery. All sedated patients, regardless of your age, will need to be accompanied by an adult to drive you home.
X-Rays
If your dentist has taken x-rays, we would appreciate you having them forwarded to our office. Our front desk coordinators will follow up with your provider’s office. Additional digital images can be taken at our office.
Insurance and Financial Information
Insurance
Alliance Oral & Maxillofacial Surgery wants to do everything humanly possible to provide you with the best care, and the most workable financial options. We are known for going above and beyond our competitors in that we accept most insurance plans and can happily file paperwork with primary and secondary insurance providers.
To ensure there are no hiccups in payment for your care, please have your medical and dental insurance cards at hand when you call to make your appointment. Please also bring these to your first office visit as well.
If you have any questions or concerns at any time, please don’t hesitate to ask our staff.
Financial Policy
Alliance Oral & Maxillofacial Surgery strives to provide the finest care at the most reasonable cost to our patients. Payment is due at the time service is rendered. If you are uninsured, or your insurance doesn’t cover the full cost of your procedure, Alliance Oral & Maxillofacial Surgery accepts Visa, MasterCard, American Express, and Discover. We also partnered with Care Credit, which provides flexible financing options, including interest free payments.
When we submit a claim to your insurance, they should respond within six to eight weeks. Any balance remaining, after your insurance has paid, is your responsibility. Prompt payment of any outstanding balances is always appreciated. If you have questions regarding your account, please contact us.
Privacy Policy
In compliance with local, state and federal laws, we have made our notice about our privacy practices, legal duties, and your rights concerning your health information publicly available. This notice also outlines how certain information about you may be used and disclosed, and how you can obtain access to this information. Please view or download our Notice of Privacy Practices for your information.
